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2005, 05-11 Permit: 05001541 Plumbing Reversal, ROWSpokane Valley BUILDING DIVISION 11707 E. Sprague Avenue, Suite 106 Spokane Valley, WA 99206 1 Site Information Project Information Site Address: 215 N BLAKE RD Parcel Number: 45154.1504 Subdivision: Block: Lot: Zoning: AGS Owner: HUNSBERGER JR, KENNETH P Address: 215 N BLAKE RD SPOKANE VALLEY, WA 99216 Building Inspector: BARRY HUSFLOEN Water Dist: Project Number: 05001541 Inv: 1 Issue Date: 05/11/2005 Permit Use: PLUMB REVERSAL W/RD OBSTRUCT FOR SEWER CONNECT Applicant: NORM'S Excavating P.O. BOX 574 VERADALE, WA 99037 Contact: NORM'S Excavating P.O. BOX 574 VERADALE, WA 99037 Phone: (509) 928-0580 Phone: (509) 928-0580 Setbacks - Front: Left: Right: Rear: Group Name: Project Name: ROW Permits Plumbing Perini! Contractor: BELKNAP PLUMBING License p: BELKNP*071D6 WATER PIPING - D W V FOR PLUMBING INSPECTIONS CALL (509) 688-0054. 1 $6.00 PROCESSING FEE $35.00 Total Permit Fcc: $41.00 Right of Way Contractor: NORM'S EXCAVATING INC License #: NORMSEI972BM CONST IN ROW -SEWER 1 FOR RIGHT OF WAY INSPECTIONS CALL (509) 869-5373 ENGINEERING $16.00 ROW INSPECTION 1 $25.00 Total Permit Fee: $41.00 Payment Summary Total Fees AmountPaid AmountOwinp $82.00 $82.00 $0.00 Tran Date Receipt # Payment Amt 05/11/2005 Processed By: DOMPIER, DAWN Printed By: MIKE TURBAK Page 1 of 1 1286 $82 00 PERMIT Apr 25 05 11:28a NORMS EXCAVATING *lane �� , Ualley 5098920432 Call 24 hours before inspection required Phone7509.688-0195 Fax 509.688-0037 DEPARTMENT OF PUBLIC WORKS Q5 p.12 Anticipated start date 5(16!05 Permit # ROW CONSTRUCTION PERMIT Location of property 215 N. Blake Applicant Name Soderquist (Address/Parcel #, if available) Account# 000122 Address Same Fax 892-0482 Contractor's Name Norm's Excavating. Inc. Address PO Box 574 Veradale, WA 99037 Phone 5091928-0580 Contractor's Reg# NORMSEI972BM Expires 01/14/07 PROJECT DESCRIPTION (Provide site sketch or plan as necessary for clarity) Sewer Connection Driveway x Curb & Gutter 71 Cable/Conduit/Pole ri Other Pavement Cut ❑ Gas Installation/Repair n Sidewalk Repair/Construction Dimensions Bond/insurance certification must be on file with the City. Bond # 103957298 SPECIAL CONDITIONS: Permittee Signature Approved Date I hereby authorize the City of Spokane Valley to charge the fee for this permit to my credit card. Card # Expiration Date 09130/05 Name of Holder Sheila Gibbons Signature Fees Paid$ 16.00 $25.00 Date [nit (Application) (Inspection) In addition to the permit application fee of $16.00 (utility) or $25.00 (construction), inspection on each permit will be billed to the permittee at a rate of $50.00 per hour with a $25.00 (12 hour) minimum. Permittee signature constitutes an agreement to these terns and provisions. Work completed satisfactorily (Signed) Date Permit not valid until One -Call Notification Ticket # entered here PERMIT MUST BE KEPT ON SITE RPR 25 2005 11:38 5098920432 PRGE.12